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Along the way, as I was helicoptered off Algonquin Mountain, wheeled into the Lake Placid ER, then driven by ambulance to Saranac Lake ER and wheeled into midnight surgery, the forest rangers, the nurses, the EMTs and doctors would ask what I did for a living. When I explained I was a writer, the response was often how at least I’ll be able to write about all this when it’s over. I certainly played the part of WRITER, reminding my husband again and again, when I was sprawled out on the trail and waiting to be rescued, to make sure my little green notebook and my pen went with me when I was helicoptered out. I kept this notebook beside me at all times, except for the surgery that would insert a metal rod and screws into my leg and ankle. I planned on recording my observations, the odd angles and discolorations of my leg, the various textures of pain, the bright personalities of the nurses, the sounds from the other hospital rooms, the kindnesses.

But here’s a confession: I barely used that notebook. I have three measly pages to cover my first week of injury. My writer self, a previously eager observer of my life’s lows, appeared to be asleep or absent, cowering off in some corner of my mind. I’m still trying to understand why.

Despite my lackluster notetaking, I can remember certain moments if I try. My nails digging into my husband’s arm and leaving marks. A stranger covering me with his rain jacket. How I couldn’t stop shaking. The helicopter circling over us, needing to burn off fuel, while the trees around us trembled and blew as if in a storm. I remember asking my husband to shoot me. I remember rising above the trees while strapped into a harness, and suddenly there was so much light from the setting sun. I intended to wave goodbye to my children but I was spinning the wrong way.

But there are other moments that I can’t access. In particular, the time between when I was walking down a trail beside some rocks, not even a steep part, and I noticed a man to my lower left, and I was thinking, I do not feel like saying hello to this man, as I was tired of greeting people—then, somehow, I was on my back, and this kind man, the one I didn’t want to greet, was crouched next to me, explaining I’ve been hurt. That I was really hurt. I glanced at my leg, bent in angles that should have been impossible. Then I closed my eyes.

Between those two moments, there is nothing.

I want to know what my body was doing during that nothing time. More accurately, I want to be able to describe what my body was doing and what I was thinking and feeling. I wish someone was taking a video so I could see myself fall. It’s strange, as a writer, disorienting, to have moments, no matter how brief, unavailable to me. Did I slip? Stumble? Push myself off the rocks? Twist? Flail? Leap? Scream? Cry out? (Apparently the brain stops recording memories during traumatic events, focusing its resources instead on survival, due to increased adrenaline and noradrenaline production, says Scientific American.)

I’m glad, of course, my brain stayed focused and I survived. But I still wish my writing self could have been an observer, just as I wish that same self could have been more present during the times of intense pain. When, for instance, the forest ranger was preparing to splint my leg without pain meds while my tibia was almost pushing through my skin. I needed to be splinted before I could be lifted up to the helicopter. “Ready?” the ranger asked. A quiet voice in my head was telling me to pay careful attention, but the voice was so muted, and then I began screaming, as the pain went beyond what was bearable. I went elsewhere, to a place I may never be able to describe, and there is some disappointment about visiting a place, however bleak, where there aren’t words.

I am trying to write about my experience three months after the accident. One problem I keep encountering is the fact this was an accident, an awful twist of fate. I write awful but another problem is it wasn’t that bad, not when put into the context of greater suffering in the world. Yes, I felt intense pain while waiting for the helicopter. Yes, the waiting felt infinite but actually it was 2 hours. Yes, the splinting was intolerable, but that lasted no more than a minute. After that, I was rescued, saved, medicated, taken care of. My hospital room had a lakeside view with a loon! I know people have felt much worse, and been more frightened, for much longer. I know some people are never rescued.

How can one’s pain be made more interesting? More complex? More relevant? Must pain be complex or interesting or relevant to warrant writing about? How does one write about a violence that has no perpetrator, no blame? Were I assaulted on the mountaintop, had someone thrown me down those rocks, there would be a villain, and presumably a motive, and therefore there would have been a clearer story to tell. But what happened was the trail was slippery, and I slipped. I can’t even blame my boots. I checked them later on. The treads were fine. Everybody was falling that day, my husband has reminded me. He fell moments before I did. A woman fell moments before him, slicing open her arm. At times, it seems I could sum up my accident in a sentence or two. Yet I can’t shake this need to continue writing about it.

The accident happened at the start of an annual family vacation. I was in no shape to drive home, so my initial two weeks of recovery were spent in the Adirondacks, on various beds and scenic benches. I expected I would get much reading and writing done. A mini-writing retreat, I thought! How nice. I made my husband download the stories I was working on to a laptop using the hospital Wi-Fi. I stocked my Kindle with non-fiction I had meant to read months ago. I had my pile of articles about global warming, police surveillance, that sort of thing. But even with time stretching in the way it does in hospitals—eternity was available, nothing was expected of me—any writerly impulse quickly evaporated. Reading non-fiction put me to sleep. Not a deep sleep, but a sleep lasting for only a few minutes. I’d wake up and doggedly read a few more paragraphs before nodding off. My folder of articles lay untouched on my bed. My notebook lay beside me. The laptop remained unopened. I stared at the wall more than I thought possible, the pain meds keeping boredom away. When a volunteer wheeled in what she called her “comfort cart,” I eagerly grabbed for the easy escape of People magazine.

Perhaps it’s silly, after an injury, to become frustrated with one’s self for a lack of artistic interest in one’s situation. Perhaps the situation was simply not that interesting. Perhaps it’s okay I found more engagement with the amount of calories a celebrity consumes in a day. But I think there was something more going on, a collection of evidence, or a sinking feeling.

The first book I was able to latch onto in the hospital was Cormac McCarthy’s The Road. It’s a novel I come back to every year or two. I read it before I had my first child and thought, well this is rather showy and dramatic, isn’t it. After the birth of my first child, I read it again and wept. I don’t cry anymore at the ending, but I do find solace in its portrayal of an effective parental love and a useful suffering. The dad does manage to save his child in the end, after all. In the hospital setting, I found this novel’s bleakness to be reassuring, its descriptions of the decimated, impersonal, and brutal wilderness to be more accurate than the romantic description of trees I’ve encountered elsewhere. I would read the book, fall asleep several pages in, then wake and read more, and fall asleep, and cry because my leg hurt so much, take the pain meds, and read more. Read in this fragmented way, certain scenes stretched on practically forever. I think the father swimming out to the ship went on for most of one night. I must have reread certain parts, and I was reading so slowly. But I feel like this particular reading of the book was my truest reading, the most accurate. Perhaps suffering, no matter how pointless such suffering is, is the best state of mind when reading a book about suffering. I found solace in the idea that suffering can have a purpose, a goal. Even my suffering, I wondered? A purpose larger than the personal, I wondered?

I carried my notebook with me everywhere while I used crutches. I carried it to a second visit to the Saranac Lake ER because my leg had turned a deep rich blue and swelled to an obscene size. “I’m turning into a blueberry. Like Violet Beauregarde!” I told my daughter, who patted me with alarm. I rarely wrote in the notebook. I just carried it, occasionally jotting down commandments from my doctors. Elevate. Ice. Rest. I took the notebook to the final appointment with my surgeon, whom I had fallen in love with. I say this in the most sincere, non-creepy way possible: here was a man who had put my leg back together. A man who had smiled at me with such kindness before the surgery, when I was very frightened, and afterwards, who moved my bandaged leg with great pride. It was like we had created something together. “Look at that!” he said with a little awe, moving my leg up and down. I don’t know how people cannot fall in love with their surgeons. I suppose there is a story waiting somewhere in that proclamation.

My writer self eventually did wake up. Proudly, now, it waves around its updated list of things it can write about more accurately and personally: a mountain injury! A helicopter rescue! An ambulance ride! Being wheeled into a frigid operating room and hearing Pink Floyd! Going under for surgery! Metal implants in one’s leg! Becoming hysterical from pain while one’s children watched. The queasy loneliness of a hospital room at night.

I could turn it all into a story, adding some kind of tension, or forcing something more to happen. Give the injured wife and her husband a history, perhaps a violent history. Or maybe the child could be the one injured, and the mother would have to watch her child in pain rather than watching her own pain. But part of me has become bored with reshaping the details of my life into a narrative with an exciting enough plot that also satisfies a need for completion and revelation by the story’s end. Part of me wants this experience to be enough as it was.

I will get back almost everything that I lost. I’ll be able to walk without a limp. At some point, I should be able to run. My family will go back to the mountains and have a proper vacation. And there have been little gifts along the way. Reading returned to me in a fury once I went off opioids at the end of week two. When was the last time I had so much space to read since I was a child? The Executioner’s Song, Borne, Fever Dream, The Book of Joan, Lincoln in the Bardo, The Handmaid’s Tale, Against Depression. I had love affairs with each of these books. I read gratefully, whole-heartedly, without distraction, as I had nothing else I could do. I read through my insomnia, and I read while my leg was elevated and iced, and I read while doing my physical therapy exercises every three hours, and I read to my children while I rested, and I listened to the books as I hobbled around the block.

What I won’t get back are those moments I can’t remember, the falling, the pain. Those are the parts, if I do tell this story someday in its completion, I will have to make up.

Here are some of the ways my accident changed me. I will hike less joyfully next summer. I will hesitate on rocky trails. I will bring an emergency beacon and consider trip insurance with helicopter evacuation coverage. I may stop below the ridges of mountains rather than climb. I have lost my certainty that hiking up mountains has a point. What is the point? Gazing at them from a distance might be enough. I hope environmental descriptions in my writing will gain some kind of brutality, that I will say no to romanticism when it suggests itself, especially when the sun is setting on a scene. Because the mountain stood there while I screamed. Of course it did. And then my family, my husband and children, had to climb down it in the dark. Did I ever think nature had a heart? Yes, I suppose I did. Maybe this is the real loss or revelation. We talk so much about trying to save the natural world as if it is a living breathing person. It’s not. It’s still worth saving, but not because of its kindness.

On a two-page spread in her graphic memoir Marbles, Ellen Forney copies a partial list of artists and writers with “probable manic-depressive illness or major depression,” from Francesco Bassano to Anders Zorn, Antonin Artaud to Walt Whitman, Hans Christian Andersen to Emile Zola. There are plenty of people afflicted with mental illness who also happen to lack any artistic inclinations, but still, given such lists, one wonders: Is there a relationship between mental illness and genius? Peter Kramer fought that romanticism in his 2005 book Against Depression. “Like tuberculosis in its day, depression is a form of vulnerability that even contains a measure of erotic appeal,” he wrote in an accompanying essay in The New York Times Magazine, but the evidence that depression led to higher powers of perception, he claimed, was weak.

Still, Forney’s own battle with manic depression was shadowed by this concern. She had come to Seattle when she was in her early 20s hoping to make it as a freelance comic artist. She wanted to be brilliant, filled with heat, and thought that her clinical diagnosis of Bipolar 1 admitted her to “Club Van Gogh.” And she feared the neutering effect of medication. (It reminds you a little of Lisa Simpson’s ambitions to become a jazz musician. “I’ll avoid the horrors of drug abuse, but I do plan to have several torrid love affairs, and I may or may not die young. I haven’t decided.”) Forney’s highs could be wonderful, but also destructive, and her depths were terrible. Her chronicle of her fight is personable and unpretentious. She has her own insights into her battle, but her voice is not battle-weary.

We met for an interview in Seattle on May 31. She had recently returned from a trip to Sarajevo sponsored by the U.S. embassy where she discussed Sherman Alexie’s young adult novel The Absolutely True Diary of a Part-Time Indian, which she illustrated, with Bosnian high school students. That book won a National Book Award. Marbles has been nominated for an Eisner.

The Millions: There’s a whole set of books, that are well-written and accessible, that a psychiatrist knows to give people to read. I imagine Marbles may become one of those books. What do you think Marbles as a graphic memoir can do that, for example, Darkness Visible can’t do?

Ellen Forney: I think that comics and the arts of painting and music offer a certain emotional quality, an emotional communication that a text doesn’t have. I’m not saying it’s better or worse. I’m saying it’s different. When the story is about mood or a set of moods, [then] having a picture, having a drawing style, having a visual representation of that…explains what [these different moods] feel like in a way that text just can’t. I also think that comics in general, for the most part, are approachable in a way that text isn’t.

TM: I always think of comics as a form of handwriting. When you get a letter that is handwritten, you have an idea of the body of the person who wrote that letter. Some of my favorite comics are a bit naïve, a bit rough, and appear unpolished even if they are carefully done. I think your comics appeal to that sensibility.

EF: It’s where my style naturally lands. The analogy that I make a lot when I look at someone’s very polished work [like] Dan Clowes or Charles Burns is a food analogy. Their work is like sushi. It’s so perfect, or if it is imperfect, it’s in a very perfect way. Whereas in my work, and I think we share that preference, is like lumpy oatmeal cookies that somebody baked. They have a very different appeal. It has an approachability. It has a different kind of emotional appeal. There’s a sense of conviction that’s different.

But I want to add one thing about handwriting. Without belaboring the point, I think it’s a travesty that so many cartoonists are turning to making a font out of their letters for exactly this reason. That feeling of a handwritten letter…Excuse me, I can’t remember how you put it.

TM: That you can imagine the body behind the hand doing the drawing.

EF: Right. And a sense of time in a way. When you see somebody’s handwriting, you know that there’s a span of time. There’s always that sense of feeling cheated when you compare all of the “a”s and they’re all the same. There’s something superficial about it. The letters don’t come together. I just feel that [handwriting] is far superior as far as storytelling [is concerned], as a method of communication in particular.

TM: When you are bipolar it’s very hard when you are in your depressive states to access the emotions of the high states and it’s also hard when you are in your high states to channel the emotions of your down states. I’m in a meditation group. One of the exercises we try to do is to access our unhappy emotions in order to see what they do to our bodies. And it’s very hard to do that on cue. And I imagine when you were composing your book it was very difficult to access these different states.

EF: I had a lot of material from that time specifically to draw from to jog my memory. I had years of journals. I don’t know how I would have done this without journals. The drawings I did in my journals I did when I was depressed. [I was also] talking with friends and people in my family about what I was like, which was extremely difficult, and just remembering, letting myself and making myself go there. It was really really difficult. It was a very thorough exposition of things that were anywhere from cringe worthy — a lot of the manic stuff was “ooh cringe” — to some extremely painful depressive stuff. And once you got there, you remember a lot more and it was really emotionally intense.

TM: When you were immersing yourself in those depressive states, were you afraid of accessing some memory that would trigger something in you that would return you to a place you couldn’t get back from?

EF: This is funny. Most people don’t ask me about this. [They’ll ask,] “Was it therapeutic for you?”

I felt like I was grounded. But I was extremely challenged. My psychiatrist was very much in touch with me, making sure I was staying steady. It was immersion therapy. I set up a tripod and posed for every panel. I was drawing myself crying and lying. I was so grateful towards the end that I wouldn’t have to keep setting [that up anymore]. I got a chair that looked like my psychiatrist’s chair. I realized I would have to be drawing that over and over. So I posed like my mother. I posed like my psychiatrist. And really, literally embodying these other characters, me and people who were around me, thoroughly immersing myself in that world and that time.

TM: I think Alison Bechdel used the same strategy when she made Fun Home.

EF: Yeah, she did. I think a lot of cartoonists use that. I think a lot of people think we draw out of our heads. And they think we’re not so good if we don’t draw out of our heads.

TM: This memoir is set at the time when you were writing I Was Seven in ’75 [a biographical strip about her childhood]. Do you see the symptoms of your bipolar disorder in the way I Was Seven in ’75 looks now?

EF: It was odd. I remember being manic and walking over to a table of people and asking them about what crossed pinkies meant for them. Does it mean if you say the same words at the same time or does it mean that you’re holding hands in a shy way? I was doing these spontaneous interviews.

TM: And you think that was a kind of mania.

EF: Not entirely. That’s in my personality even now. But I can remember there being an excitement and a heat behind it.

Some parts of the strip are really wordy — a lot of my work is really wordy — but it’s wordy in a way that I can recognize as being part of being revved. And I remember another point where I just did a lot of really literal drawings when I first got really depressed. At the end of a story about my dog there was just a drawing of me holding my dog. I think I even traced it from a photo. And I just couldn’t get very far thinking when I was in the depths. Yeah, in my first months when I was really depressed, that’s all I could really do. How I did that, I don’t actually know. Looking back, I don’t know how I managed to get this silly comic together.

TM: When you get diagnosed with a disorder of any sort you fear that your personality can be reduced to a few lines in a handbook. And nobody likes that. We all think of ourselves as being more idiosyncratic and interesting. Do you fear that some of your political beliefs, some of your sexual energy as evidenced in your book Lust [a collection of illustrated erotic personal ads she did for The Stranger], some of your personality can be reduced to this mental disorder?

EF: One of my fears for years in telling people that I was bipolar or coming out [as bipolar] when Marbles came out was that people that I knew or people I would meet would second-guess everything that I did, wondering if it was because I was bipolar. For myself, it’s impossible to distinguish between these different aspects. I know the things that I do that could be considered manic-y, or in the case of Lust, hyper-sexual by some. But I think [those things are] all a healthy part of me, my personality.

At the same time, I think that a lot of people will think of a mental disorder as being something other than themselves. Well, let’s see, not even mental disorders, but say, for example, someone was drunk. “That wasn’t me, that was the liquor talking or that was any sort of substance talking or that was the depressed me.” I think that it’s understandable [to say that]. But we also have to acknowledge that that’s part of us. That person who acted out when you were drunk…That was you. I don’t want to give anyone advice on their own identity, but I think it’s an important thing to think about.

That person who won the marathon. You’re not like that all the time. The person who fell off the curb. Well, of course you’re not like that all the time. But that was you and that was you.

TM: There’s a note of fear at the end of your book, that you’re managing what you have and you’re hoping that it stays managed, but you don’t know where it’s going to go. Do you feel if you were to relapse you would be responsible for writing a sequel?

EF: I wouldn’t have to tell any stories that I don’t want to tell. I didn’t feel that I had any responsibility to tell anything.

I mean I would do a [a story about a] relapse if it were a good story. I don’t know if that would be that interesting a story. I don’t know if that would be that interesting a sequel.

I’m looking forward to moving on.

Special thanks to Eric Reynolds of Fantagraphics for assisting in this interview’s preparation.

All images excerpted from MARBLES by Ellen Forney. Copyright (c) 2012 by Ellen Forney. Reprinted by arrangement with Gotham Books, a member of Penguin Group (USA), Inc.